Professional Documents
Culture Documents
Commercial Establishment Form
Commercial Establishment Form
ESTABLISHMENT INFORMATION
OWNER NAME : _____________________________________________________________________
(Last Name) (First Name) (Middle Name)
ADDRESS INFORMATION
STREET/PUROK : __________________
BARANGAY : __________________
MUNICIPAL/CITY : __________________
PROVINCE : __________________
REGION : ___________________
COORDINATES : (lat)__________ (long) ____________
SANITATION
SEPTIC TANK :
( ) YES ( ) NO
EASTMENT
( ) INSIDE ( ) OUTSIDE
REMARKS : ___________________________________________________________________
DATE GATHERED : _______________________
INTERVIEWER : _______________________________________
SIGNATURE OVER PRINTED NAME
Noted by:
SIMPLICIO T. PRINCIPE
Barangay Chairman